Marathon Monday… From The Outpatient Clinic

Monday afternoon, I was busy in my clinic, at this great hospital, in our great town. My medical assistant grabbed me between patients and asked, “Did you hear about the bombings?”

I had several more patients to see, but of course I checked the news. It was a bit too much to absorb. Horrible. Bizarre to think that all was quiet in our outpatient offices, while it was right there in the news that our own ER was receiving multiple severe trauma cases.

From then on, it was a topic of discussion in the clinic rooms. I opened up the topic with each patient, letting them decide how much to discuss. Everyone wanted to talk more about what was going on: how they learned about it, if they knew anyone who might be directly affected, trying to understand how someone could do something like this. It’s only human to need to talk about these things, to want to frame things, to better understand, to sort it out.

The hospital disaster coordinators sent out emails with updates: all clinical staff were asked to stay until they knew for sure what manpower was needed. All of us in the office stayed until the email came that if we hadn’t been contacted directly we were free to go.

The medical walk-in unit had been cleared to offload the emergency room of all the medical/ nontrauma or minor trauma cases (barotrauma, minor lacerations), while the emergency room handled the many major trauma cases. Offices like ours were asked to handle overflow nonurgent medical care, and NOT to send patients to the ER or walk-in clinics, if we could. So, I stayed put and saw my panel.

Even so, I felt a little useless. It was a bit of a slow afternoon for me. I imagined the blast and injuries and the care required, from the finish line, to the ambulances, to the emergency rooms. Injuries like these required calm, cool and collected care from level-headed and experienced providers: immediate stabilization with hard pressure and tourniquets, volume rescuscitation, blood products; then surgeries for extraction of shrapnel, fixation of fractures, or amputations; then attention to detail with delicate blood vessel and nerve reconstructions, burn treatment…

There wasn’t much for an outpatient doctor like me to actually do. I found myself compulsively checking and rechecking all the news feed, meeting with colleagues in the hallways, murmuring about what we heard, wondering what to do.

When I left, I walked through our lobby, past our emergency room. Security personnel were everywhere, uniformed officers and dark-suited FBI-types with earpieces. People were being directed, “Keep walking, don’t stop, keep walking!” Outside, there were rows of police cars, official sedans with tinted windows, officers and secret-service guys all over. Things were tense. I found myself striding, practically jogging through the hospital, across the grounds, to the parking garage.

They were searching bags; they searched mine, and I got to my car and got on the highway. It was a holiday, and a day many people who work downtown take off anyways, because of the marathon. There was no traffic. I got home in record time. I was so glad to see my kids, Babyboy playing in Nana’s kitchen sink, and Babygirl toddling right into my arms.

Family and friends from far away called, to check in. Many people assumed I must have been pulled in to treat traumas… I felt almost guilty that I had not.

Since then, it seems there are still no clear answers, and only more details of horror from the blast sites. The targets were innocent civilians, ordinary people and families enjoying a classic day celebrating health and physical accomplishments. Here at our office, we’ve heard from many patients who are suffering from anxiety, re-awakening of past traumas, PTSD symptoms… I’m offering reassurance, and prescribing alot of Ativan. I guess that is my small contribution…. That, and mentally preparing for the next time, when maybe I will be pulled in, to provide calm, cool, and collected care.

Fantastic post. My brother lives in Boston with his wife – was texting him anxiously as news was unfolding. Also have a partner whose daughter is at Boston College – she was at the marathon but luckily far from the explosion. We were all watching the news on pins and needles. Funny that you feel guilty for not being involved – reminds me of a med school friend of mine who transferred up to NY with her husband when he got a neurosurgery residency at Columbia. She was stationed in the morgue all night during 9/11, but she waited in vain. There were no bodies or survivors. I am glad there were survivors on Monday, despite the horrific tragedy. Hope you all are on the mend up there, you are in my thoughts.

Great post. I’ve been in cities where major tragedies have happened, too, and felt that same sense of almost guilt that my current skill set doesn’t require my help. You are indeed helping your patients deal with this, though.

THANKS all, appreciate very much the readership. I see comments but don’t always get to reply back… I try to read all your blogs too (those that have them)… This whole crazy sad terror situation.. is surreal and kind of isolating… It helps to reach out to others and share what is going on.